Overview

Medical Policies & Clinical UM Guidelines 

Welcome to HealthLink’s Medical Policies & Clinical Utilization Management (UM) Guidelines website. Our goal in creating this application is to provide you with ready access to electronic versions of medical policies and clinical UM guidelines.  

 

How to Find Medical Policies & Clinical UM Guidelines 

The tabs on this page are organized as follows: 

Medical Policies  

-Recent Updates 

-By Category 

-By Alpha 

Clinical UM Guidelines 

-Recent Updates 

-By Category 

-By Alpha 

You can locate a medical policy or clinical UM guideline by clicking on the By Category or By Alpha options under each tab. The By Category page lists each category as a link at the top of the page. To view a specific category, click the category link to be redirected. The By Alpha page lists all medical policies or clinical UM guidelines alphabetically by title. There is an alpha index at the top of the page. To find a title, click the appropriate letter to be redirected.  

You can also use the “search” feature, which is now housed in the top navigation, or by clicking the link below.  

 

Click Here to Search  

 

The following contact us e-mail address is for questions related to the research and development of medical policies and clinical Utilization Management (UM) guidelines found on this site. For those inquiries you may contact us at: Medical.Policy@WellPoint.com  

Please direct inquiries related to benefit coverage, new ID cards, billing practices, prior authorization, pre-determination or reimbursement and any other inquiries unrelated to medical policy or clinical guidelines to the local plan provider representative, billing/reimbursement department or Customer Service, as applicable, by calling the number listed on the member ID card. We will not be able to respond to those inquiries.